Algorithmic Approaches to Neurologic Conditions
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Summer 1996
Volume 7, Number 1
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Abstracts
of this issue appear
below. Send e-mail or call 303-788-4010 to order a printed copy.
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 Abstracts
Head Pain Management
Judy Lane, MD
With increased understanding of
headache mechanisms, headache treatment can be tailored.
Treatment comprises non-pharmacologic modalities as well
as traditional and new pharmacotherapies.
Epilepsy and Seizure Disorders
Ronald E. Kramer, MD
Seizure disorders and epilepsy are
common neurological conditions to which all clinical
physicians are exposed. Treatment should begin with one
antiepileptic drug. If this strategy of monotherapy
fails, then polypharmacy can be entertained. Several new
drugs are on the market for the purpose of polypharmacy.
If patients continue to have seizures despite appropriate
treatment, then advanced diagnostic and therapeutic
interventions need to be considered. At all stages of
treatment, attention to important psychosocial issues,
such as driving, family planning, and employment need to
be addressed to maximize medical outcomes.
Numb Hands: Carpal Tunnel Syndrome
Marc M. Treihaft, MD
Carpal tunnel syndrome is the most
common mononeuropathy. Symptoms and signs are caused by
entrapment or compression of nerves in the wrist and
palm. A detailed history including attention to
occupational stresses, physical examination and
electrodiagnostic studies are essential to confirm the
diagnosis. Guidelines for conservative treatment and
surgical intervention are reviewed.
Multiple Sclerosis
Jack S. Burks, MD
Multiple Sclerosis (MS) has emerged
from being a disease that was difficult to diagnose and
impossible to treat. Making the diagnosis has been
facilitated by Magnetic Resonance Imaging (MRI) scanning.
Treatment are now available that favorably change the
disease course. Many MS symptoms are treatable with
specific medications. Rehabilitation interventions and
psychosocial counseling to help patients adapt, adjust,
cope and live a higher quality of life. This chapter
attempts to condense complex treatment issues to brief
algorithms that may be useful in developing clinical
pathways for individual patients. While no clinical
pathway tells the whole story, this article attempts to
focus the reader’s attention on current therapeutic
options.
Reflex Sympathetic Dystrophy
Neil L. Pitzer, MD
Reflex Sympathetic Dystrophy (RSD)
is a disorder commonly associated with burning pain,
edema, and hyperesthesia. It can develop as a sequelae
after a multitude of injuries or disorders. Early
recognition and accurate diagnosis is critical to
appropriate treatment. Comprehensive therapy, medication
use, nerve blocks, and even surgery may be needed to
reverse this disorder. An aggressive home treatment
program is a cornerstone of success. Recommendations and
an algorithm are presented as guidelines for treatment.
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